Individual
MS. MARIANNE P KELLEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PSYD LP
Contact information
Practice address
821 RAYMOND AVE, #200, ST PAUL, MN 55114-1509
(651) 645-8300
(651) 645-4603
Mailing address
821 RAYMOND AVE, #200, ST PAUL, MN 55114-1509
(651) 645-8300
(651) 645-4603
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3511
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01014479
PREFERRED ONE
MN
01
—
06Q72KE
BLUE CROSS
MN
01
—
HP18714
HEALTH PARTNERS
MN
Enumeration date
04/22/2006
Last updated
07/08/2007
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